Doctors have urged ministers to scrap a wide–ranging reform of the National
Health Service during an emergency session of the British Medical
Association.

The GPs' and hospital consultants' body called on Andrew Lansley, the Health Secretary, to "halt the proposed top–down reorganisation of the NHS" during its first "special representative meeting" in almost 20 years.

They warned that the introduction of greater competition would damage patient care, and claimed the proposals were rushed and not backed by evidence.

Dr Hamish Meldrum, the chairman of the BMA Council, cautioned against going too far in case it weakened their negotiating position with ministers. A motion for outright opposition to the Health and Social Care Bill was lost, as was a vote of no confidence in Mr Lansley.

The Government pointed out last night that some doctors were in favour of a significant part of the Bill, which would allow them, rather than middle managers, to purchase treatment for their patients. They would also have to consider private health care providers rather than just the nearest NHS hospital.

But, although some practices have signed up to a pilot scheme, most of England's professional health bodies and lobby groups are opposed.

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The Bill will also face fierce opposition in Parliament, after the Liberal Democrats' spring conference voted against the "damaging and unjustified market–based approach" and Labour tabled amendments that would water it down.

Opening the BMA meeting, Dr Meldrum said: "The Government's proposed reforms have far–reaching and potentially irreversible consequences for how the NHS is run and the way we deliver care to our patients."

He described the plans as "often contradictory, driven by ideology rather than evidence, enshrined in ill–thoughtthrough legislation and implemented in a rush". He warned that doctors would be blamed if patient care suffered.

The meeting overwhelmingly backed a call for the Government to withdraw the Bill and opposed the concept of "any willing provider" for services.

One speaker said that private health firms would "cherry pick" services by refusing to treat the obese or those with mental health problems.

But a motion supporting "clinician–led commissioning", in which doctors buy treatment for their patients, was passed.

Dr Jacky Davis said: "This Bill is the final step on the way to the privatisation of the NHS. The Bill has few friends outside the private companies waiting to make billions out of it."

But her motion for outright opposition was opposed by 54 to 44 per cent.

The BMA Council will consider its next moves at a meeting today.

Its options include a ballot on industrial action – which has not taken place since 1975 – but this looks less likely after the meeting also voted to keep negotiating with ministers.

Last night, Simon Burns, the junior health minister, said: "It has been a day of confusing messages from the medical union, the BMA. Fortunately our policy of protecting the NHS budget and its values remains clear."

John Healey, the shadow health secretary, warned that hospitals and doctors could be fined millions of pounds for running "cartels" under the proposed reforms.